hs-cTnI、NT-proBNP及PCT预测主动脉瓣狭窄患者瓣膜置换术后发生不良事件的可行性

Feasibility of hs⁃cTnI,NT⁃proBNP and PCT in predicting adverse events after valve replacement in patients with aortic valve stenosis

目的分析高敏肌钙蛋白I(hs-cTnI)、氨基酸末端B型脑钠肽前体(NT-proBNP)及降钙素原(PCT)预测主动脉瓣狭窄(AS)患者瓣膜置换术后发生不良事件的可行性。方法选取2020年7月至2022年1月聊城市人民医院收治的AS患者99例为研究组,另选取同时期本院体检中心健康体检者93名为对照组。对比正常人群与主动脉瓣狭窄患者hs-cTnI、NT-proBNP及PCT水平;对比不同狭窄程度AS患者hs-cTnI、NT-proBNP及PCT水平;比较有无不良事件发生患者的临床资料,采用多元Logistic回归分析影响AS患者术后不良事件发生的相关因素。结果研究组hs-cTnI、NT-proBNP及PCT水平均显著高于对照组,差异有统计学意义(P<0.05)。AS患者hs-cTnI、NT-proBNP及PCT水平:重度狭窄>中度狭窄>轻度狭窄,差异有统计学意义(P<0.05)。经随访后发现,不良事件组30例,无不良事件组69例。两组性别、年龄、既往病史、吸烟、体质量指数、收缩压及舒张压比较,差异无统计学意义(P>0.05)。两组狭窄程度、hs-cTnI、NT-proBNP及PCT水平比较,差异具有统计学意义(P<0.05)。多元Logistic回归分析结果显示,狭窄程度、hs-cTnI、NT-proBNP及PCT水平是影响AS患者术后不良事件发生的危险因素(P<0.05)。结论hs-cTnI、NT-proBNP及PCT水平与AS发生、病情程度具有密切联系,通过检测上述水平预测AS患者瓣膜置换术后发生不良事件具有一定可行性,可为临床治疗方案提供参考价值。

Objective To analyze the feasibility of hypersensitive troponin I(hs⁃cTnI),amino ac⁃id terminal B⁃type brain natriuretic peptide precursor(NT⁃proBNP)and procalcitonin(PCT)in predicting ad⁃verse events after valve replacement in patients with aortic valve stenosis(AS).Methods 99 cases of AS pa⁃tients admitted to our hospital from July 2020 to January 2022 were selected as the study group,another 93 cas⁃es of healthy patients who underwent physical examination in the physical examination center of our hospital dur⁃ing the same period were selected as the control group.The hs⁃cTnI,NT⁃proBNP and PCT levels were com⁃pared between the normal population and patients with aortic stenosis;the hs⁃cTnI,NT⁃proBNP and PCT levels were compared in AS patients with different degrees of stenosis;the clinical data of adverse events were com⁃pared,and multivariate Logistic Regression analysis of multiple factors affecting postoperative adverse events in AS patients was preformed.Results The levels of hs⁃cTnI,NT⁃proBNP and PCT in the study group were sig⁃nificantly higher than those in the control group,the difference was statistically significant(P<0.05).The levels of hs⁃cTnI,NT⁃proBNP and PCT in AS patients were severe stenosis>moderate stenosis>mild stenosis(P<0.05).After follow⁃up.There were 30 cases in the adverse event group and 69 cases in the no adverse event group.There were no significant differences in gender,age,past medical history,smoking,body mass index,systolic blood pressure,and diastolic blood pressure between the two groups(P>0.05).There were statistically significant differences in the degree of stenosis,hs⁃cTnI,NT⁃proBNP and PCT levels between the two groups(P<0.05).The results of multiple Logistic regression analysis showed that the degree of stenosis,hs⁃cTnI,NT⁃proBNP and PCT levels were multiple factors affecting the occurrence of postoperative adverse events in AS pa⁃tients(P<0.05).Conclusion The levels of hs⁃cTnI,NT⁃proBNP and PCT are closely related to the occur⁃rence and severity of AS,and is feasible to predict the occurrence of adverse events in patients with AS after valve replacement by detecting the above levels,which provides reference value for clinical treatment plans.